This publication presents selected data about the health of Indigenous and non-Indigenous Australians from the 1995 National Health Survey (NHS). Topics include measures of health status, health related actions taken, and lifestyle factors which may influence health.

Due to concerns about the quality of data collected for Indigenous people living in remote areas, results for all people (both Indigenous and non-Indigenous) from remote areas have been excluded from this publication. (For more details, see the Explanatory Notes, Summary of Data Quality Investigations, and Glossary.) In addition, people who were inpatients in hospitals, or living in nursing homes or other institutions were not included in the survey. Thus the results reported here describe the health of non-institutionalised Indigenous and non-Indigenous Australians living in predominantly urban and more densely populated rural areas.

Throughout this publication, data are presented separately for Indigenous and non-Indigenous people to allow for comparison. Because the Indigenous population is considerably younger than the non-Indigenous population, and because health-related variables may differ according to sex, results for Indigenous and non-Indigenous people are presented separately by age group and sex wherever possible. Data for people aged 55 years or more have been grouped together because there were too few older Indigenous respondents to allow for further age divisions.

The following graph displays the relative age profiles for the Indigenous and non-Indigenous populations. The corresponding population estimates can be found in the Appendix.

Although it is recognised that there is considerable diversity within the Indigenous population, separate estimates for Aboriginal people and Torres Strait Islanders could not be presented due to the small numbers of Torres Strait Islanders surveyed.

It should be noted that the results presented here are all based on information as reported by survey participants; they may not agree exactly with information collected in other ways, or from other sources, such as medical records. No attempt has been made in this publication to compare results from the NHS with results from other data sources.

HEALTH STATUS

Self-assessed health status The majority (73%) of Indigenous people aged 15 years and over reported their health to be ‘good’, ‘very good’ or ‘excellent’ at the time of the survey, with the rest reporting their health as ‘fair’ or ‘poor’ (table 1). By comparison, 83% of non-Indigenous people aged 15 years and over reported their health status as ‘good’, ‘very good’ or ‘excellent’.

As can be seen in the graphs below, Indigenous males and females were more likely to report fair or poor health than their non-Indigenous counterparts in almost every age group. Reporting of fair or poor health increased with age among both Indigenous and non-Indigenous people, but the increase began earlier and was more pronounced among Indigenous people. After adjusting for age, Indigenous people were about twice as likely as non-Indigenous people to report poor or fair health.

It should be noted that self-assessed health status may be affected by factors such as awareness of and expectations about health, access to health care and health information, and perceptions of one's own health relative to that of others in a person's community.

Reported recent and/or long-term conditionsInformation on recent illnesses and long-term conditions was collected using different types of questions, and the distinction between the two may be somewhat artificial, partly due to the self-reported nature of the data. For example, some people reported typically chronic conditions, such as diabetes, as recent illnesses but did not report them as long-term conditions. Others reported coughs or sore throats as long-term conditions but not as recent illnesses. For most purposes, combining recent and long-term conditions will provide the most useful information, and the commentary in this publication is based on combined data. However, separate tables for recent illnesses and long-term conditions have also been included because these figures may be more appropriate indicators for some purposes.

The majority of Indigenous and non-Indigenous males and females in every age group reported at least one recent or long-term condition (table 2). In total, only 24% of Indigenous people and 14% of non-Indigenous people did not report any recent or long-term conditions.

The proportion of people reporting conditions increased with age, from about 60-65% of children less than five years old to over 99% of people aged 55 or more. After adjusting for age, Indigenous and non-Indigenous people were similar in the proportion reporting conditions.

Type of conditionThe most commonly reported types of conditions for Indigenous people were diseases of the respiratory system (reported by 37% overall) and diseases of the nervous system (34%) (table 5). These same two categories of diseases were also the most commonly reported overall for non-Indigenous people.

The proportion of people reporting respiratory diseases did not vary much with age for either Indigenous or non-Indigenous people, ranging from 31% to 41% across age groups (table 5). This category includes such conditions as asthma, sinusitis, hayfever, the common cold, bronchitis, emphysema and influenza. In contrast, diseases of the nervous system (primarily eye/vision problems and ear/hearing problems) increased markedly with age, from 12% of Indigenous children under five years, to 92% of those aged 55 years or over.

A large proportion of Indigenous and non-Indigenous people reporting diseases of the nervous system cited eye/vision problems, the reporting of which ranged from under 4% in the youngest age group to over 90% in the oldest age group (table 5). Non-Indigenous people were more likely than Indigenous people to report eye problems in every age group except the youngest. The majority of eye problems reported were disorders of refraction and accommodation, such as far-sightedness, near-sightedness and astigmatism.

Ear/hearing problems were reported by between 5% and 29% of Indigenous and non-Indigenous people, depending on age (table 5). The highest reporting was in the oldest age group, with partial or complete deafness being the most common problem. In the youngest age group, by contrast, otitis media (a type of ear infection) was responsible for the majority of ear/hearing problems. The differences between Indigenous and non-Indigenous people varied according to age group.

Among specific conditions, asthma was the most commonly reported condition for Indigenous children aged less than five years (17%) and 5-14 years (23%), and among young adults aged 15-24 years (20%) (table 5). Although not the most common condition in older age groups, it was still reported by 16-17% of Indigenous adults. Asthma was more commonly reported for Indigenous people than for non-Indigenous people in every age group.

Reporting of diabetes was 7-8 times higher among Indigenous people than non-Indigenous people among those aged 25-44 and 45-55 years, and more than twice as high among those 55 years or more (table 5). Diabetes was reported by 7% of Indigenous adults aged 25-44 years, 24% of those aged 45-54 and 17% of those 55 and over.

Hypertension was also reported by significant proportions of Indigenous adults, rising from 12% of those aged 25-44 years to 33% of those aged 45-54 years and 32% of those 55 years and over (table 5). Among non-Indigenous adults in the same age groups, hypertension was reported by 4%, 14% and 36%, respectively.

Arthritis was one of the most common conditions among those aged 55 or more, reported by 40% of Indigenous people and 45% of non-Indigenous people (table 5). About 8% of Indigenous people aged 25-44 years and 17% of those aged 45-54 years reported they had some form of arthritis.

Conditions reported to be the result of an accident or incidentOverall, the proportions of Indigenous and non-Indigenous people reporting conditions as the result of an accident, incident or exposure to a harmful factor were very similar (about 16% in each group), but there were differences by age and sex (table 6). Males were generally more likely than females, and adults more likely than children, to report a condition resulting from an accident, incident or harmful exposure.

HEALTH-RELATED ACTIONS

Some 64% of Indigenous people and 76% of non-Indigenous people reported taking at least one health-related action in the two weeks prior to interview (table 7). Reports of health-related actions were more common among non-Indigenous people in all age groups for females and in many age groups for males. Indigenous and non-Indigenous males were less likely overall to report taking an action than their female counterparts.

Type of action The use of medication was the most common type of health-related action taken in the two weeks prior to interview by both Indigenous and non-Indigenous persons (table 7). Consultation with a doctor and the use of vitamins, minerals, natural or herbal medications were the second or third most common types of action among Indigenous and non-Indigenous people. These three types of health-related actions were relatively common across all age groups and for both males and females.

Medication use About 46% of Indigenous people and 59% of non-Indigenous people reported using medications in the two weeks prior to interview, although much of the difference was eliminated after accounting for age.

Pain relievers were the most commonly used type of medication, reported by 16% of Indigenous people and 24% of non-Indigenous people overall (table 10). Although type of medication varied by age group, pain relievers were the first or second most commonly reported medication in every age group for both Indigenous and non-Indigenous people. For the Indigenous population as a whole, asthma medication ranked second (10%), followed by medication for coughs/colds (6%) and skin ointments (6%).

Use of medication for heart problems/blood pressure was reported by a lower proportion of Indigenous people than non-Indigenous people overall (6% and 11% respectively), but this difference is almost completely accounted for by the higher proportion of older people in the non-Indigenous population. Within every age group except the oldest one (55 years or more), Indigenous people were more likely than non-Indigenous people to report using medication for heart problems/blood pressure. Almost one in three Indigenous people aged 45-54 years reported taking such medications, compared with one in eight non-Indigenous people. In the same age group, 15% of Indigenous people and 2% of non-Indigenous people reported taking medication for diabetes.

The use of vitamins, minerals, natural and herbal medicines was less commonly reported by Indigenous people than non-Indigenous people both overall and in every age group (table 7).

Doctor consultations and hospital visitsAlthough Indigenous people overall were slightly less likely than non-Indigenous people to report consulting a doctor in the last two weeks, this was not true in every age group (table 7). Some 15% of Indigenous people reported visiting a doctor once and 5% reported visiting a doctor more than once in the two weeks prior to interview (table 8).

Indigenous people were more than twice as likely as non-Indigenous people to report having contact with a hospital (including a hospital inpatient episode, a visit to a casualty, emergency or outpatients department and/or a visit to a hospital day clinic) in the past two weeks because of their health (table 7). The difference was present in every age group but was most pronounced among those aged 25-54 years.

Different people may choose, or have access to, different service providers when they require treatment, and it can be useful to look at the combination of doctor consultations with hospital-based care. Indigenous males were more likely than non-Indigenous males to report recent doctor and/or hospital visits from about age 25 years (table 7). Among females, the differences between Indigenous and non-Indigenous people were most marked among those less than 5 years and among those aged 25-44 years, with Indigenous females more likely to report such visits. About a third of Indigenous adults aged 25-54 years reported either a doctor consultation or hospital-based care, compared with less than a quarter of non-Indigenous people in the same age group.

Dental consultations Indigenous people were less likely, both overall and in every age group, to report a visit to the dentist in the two weeks prior to interview (table 9). Dental consultations within the two years leading up to the interview were reported by similar proportions of Indigenous and non-Indigenous children aged 5-14 years (83% and 87%, respectively), but large differences were apparent among adults. Indigenous adults were more likely than non-Indigenous adults to report that their last dental consultation was more than two years ago, or that they had never visited a dentist.

Days away from school or workIndigenous people overall were slightly more likely than non-Indigenous people to report having days off school or work in the last two weeks due to their health (table 7), but the difference was largely confined to males aged 15-44 years. Among employed persons aged 15-64 years, Indigenous people were more than twice as likely as non-Indigenous people to report having one or more days off work due to illness or injury in the two weeks prior to interview (20% compared with 9%) (table 11). The majority of these absences were reported as being due to respiratory diseases (including influenza and colds), injury, musculoskeletal diseases (including back problems) or digestive diseases.

LIFESTYLE FACTORS

Smoking Among adults aged 18 years and over, just over half (51%) of Indigenous people reported they were current smokers, compared with 23% of non-Indigenous adults (table 12). Smoking was reported by 56% of Indigenous males, 46% of Indigenous females, 27% of non-Indigenous males and 20% of non-Indigenous females. The differences are not explained by age. Smoking was more commonly reported by Indigenous adults than non-Indigenous adults in every age group for both males and females. As the graphs below show, Indigenous males and females were less likely than their non-Indigenous counterparts to report that they had never smoked.

Alcohol use Indigenous adults aged 18 years and over were less likely than non-Indigenous adults to report consuming alcohol in the week prior to interview (table 13). Recent alcohol consumption was reported by 59% of Indigenous males, 40% of Indigenous females, 66% of non-Indigenous males and 46% of non-Indigenous females. The differences were more pronounced in older age groups.

Among those who reported any recent alcohol use, 21% of Indigenous males were classified as being at a high level of risk with respect to alcohol use (based on their reported consumption levels) compared with 8% of non-Indigenous males. High risk drinking was less common among females, with 9% of Indigenous and 3% of non-Indigenous female recent drinkers in the high risk category.

Physical activity Among adults aged 18 years or more, Indigenous people were more likely than non-Indigenous people to report taking no exercise for sport, recreation or fitness in the two weeks prior to interview (40% compared to 34%) (table 14). Indigenous females were more likely to report no exercise than their non-Indigenous counterparts in every age group. Among males, however, this was the case only for the 18-44 year olds.

Body mass index Based on self-reported measurements of height and weight, Indigenous adults aged 18 years and over were about twice as likely to be categorised as obese as non-Indigenous people (table 15). Among those who provided enough information to allow their body mass index to be estimated, 22% of Indigenous males and 18% of Indigenous females could be categorised as obese, compared with 12% each for non-Indigenous males and females.

Indigenous people were more likely than non-Indigenous people to be classified as obese in all age groups among females and in all except the youngest age group among males.

It should be noted that body mass index based on self-reported height and weight may underestimate actual body mass index (see, for example, How Australians Measure Up, 1995 (Cat no. 4359.0). In addition, Indigenous people were more than twice as likely as non-Indigenous people to be missing the information needed to estimate body mass index. Both of these factors could have affected the results.

Sun protection measures Indigenous people were only slightly less likely than non-Indigenous people to report taking measures to protect themselves from the sun in the month prior to interview (77% compared with 83%) (table 16).

The measures used varied by age and sex, but for both Indigenous and non-Indigenous people overall, the most common form of sun protection employed was the use of a hat, which was reported by about 58% of people in both groups. Sunglasses, protective clothing and sunscreens were also relatively commonly used among both groups, reported by about a third to a half of people. About 15% of Indigenous people and 23% of non-Indigenous people said they had avoided the sun, and another 3% in each group said they had not been exposed to the sun in the previous month.

Breastfeeding About 75% of Indigenous children aged less than four years were reported to have been breastfed, compared with about 86% of non-Indigenous children (table 17). Among those aged six months or more who had been breastfed, 60% of Indigenous children and 53% of non-Indigenous children had been breastfed for 24 weeks or more.

Type of health cover Overall, non-Indigenous adults aged 18 years or more were nearly four times as likely to report having private health insurance as Indigenous adults (43% compared with 11%) (table 18). The highest level of private health insurance was reported by people aged 45-54 years.

Indigenous people were almost twice as likely as non-Indigenous people to report having some type of government health care card, such as a Pensioner Concession Card, Department of Veterans’ Affairs Treatment Entitlement Card, Commonwealth Seniors Health Card, Health Care Card or Health Benefits Card (table 18). Possession of a government health care card was reported by the majority of Indigenous people in all but the 45-54 year age group (47%). Almost nine out of ten Indigenous people aged 55 years or more reported they had a health care card of some kind. By contrast, the proportion of non-Indigenous people reporting a health care card only exceeded 30% in the oldest age group.

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